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v2

latestOpenAPI 3.1.02026-07-31515292.8 KB

Create Dental Inquiry

post/api/v0/dental/inquiries

Headers

Idempotency-Keystring

Request body

type'CLAIMS_STATUS' | 'BENEFITS' | 'UNKNOWN' required

An enumeration.

desired_completion_datestring required

The requested completion date of the inquiry in MM-DD-YYYY format. Calls will typically be completed by the morning of the requested completion date, but in some cases may be completed earlier.

patient_namestring required

name of the patient

dobstring required

date of birth of the patient in MM-DD-YYYY format

member_idstring required

member id of the patient

group_idstring

group id of the patient

insurance_in_networkboolean

whether or not the provider is in-network. If it is not known, leave this field blank and it will be determined.

npistring

(deprecated, use billing_npi and rendering_npi instead) Ten digit NPI of the provider

billing_npistring

Ten digit NPI of the billing provider

rendering_npistring

Ten digit NPI of the rendering provider

tax_idstring required

Nine digit tax id of the provider

external_idstring

An identifier which you can define and pass in with your creation request. This is useful for tracking a specific subgroup of inquiries. For instance, you can assign a unique external id to all inquiries for a specific provider on your platform.

practice_billing_addressstring

The billing address of the practice. If omitted, the address will be determined from the NPI.

diagnosis_codesstring[]

Any diagnosis codes for the patient. If omitted, a general diagnosis code will be used.

claims_date_of_servicestring

The date of service for the claim in MM-DD-YYYY format. Only used for claims inquiries.

claim_numberstring

The claim number for the inquiry if provided by the user. Only used for claims inquiries.

additional_infostring

Any additional information about the inquiry that is not covered by the other fields. This can be used to pass in any additional information for the request. Please check with the Health Harbor team before using this field as it may not be incorporated into the inquiry unless we are already aware of it.

call_script_idstring

Optional ID of a call script belonging to your team. Use for eligibility/benefits inquiries to control which questions are asked. You can find call script IDs on the Accounts page in the dashboard. When provided, it must be a script your team created. For eligibility search, either benefits queries or this field may satisfy the requirement—see Health Harbor documentation.

insurance'AETNA' | 'HEALTHPLEX' | 'HUMANA' | 'METLIFE' | 'UNITED_HEALTHCARE' | 'UNKNOWN'

An enumeration.

benefits_queryExternalDentalEligibilitySearchQuery[]

The benefits queries for the inquiry if provided by the user. Can be either a pre-defined set of questions (e.g. STANDARD for returning patients) or an ad-hoc defined set of codes.

benefits_codesstring[]

Codes processed for a CODE_LOOKUP_BENEFITS or a CODE_LOOKUP_PRIOR_AUTH benefits inquiry. The first character in the CDT codes (D) can be optionally omitted.

is_specialistboolean

The type of provider making the inquiry. If the provider is a specialist (e.g. periodontist, oral surgeon), set this to True. If the provider is a dentist, set this to False. Defaults to False if not provided.

insurance_payor_idstring

The payor id for the insurance. Usually five characters. For example, one payor id for Aetna is 60054.

Example request

{
  "desired_completion_date": "03-19-2024",
  "patient_name": "Alex Martin",
  "dob": "01-31-2020",
  "member_id": "123456789",
  "group_id": "123456",
  "npi": "1234567890",
  "billing_npi": "1234567890",
  "rendering_npi": "1234567890",
  "tax_id": "123456789",
  "practice_billing_address": "123 Main St, New York, NY 10001",
  "diagnosis_codes": [
    "F41.1",
    "F42.23"
  ],
  "claims_date_of_service": "01-31-2020",
  "claim_number": "1234567890",
  "additional_info": "The patient is on a Medicare plan and we need to know their secondary insurance benefits.",
  "benefits_query": [
    "CODE_LOOKUP_BENEFITS"
  ],
  "benefits_codes": [
    "D1110",
    "D1120",
    "1130"
  ],
  "is_specialist": true,
  "insurance_payor_id": "60054"
}

Response

Successful Response

successboolean required
inquiry_idstring
already_existedboolean